Prices / Houston–Pasadena–The Woodlands, TX / Hospitals
Voyages Behavioral Health of Sugar Land
11931 Highway 6 South, Sugar Land, TX 77498 · CCN 454156
Source: the hospital's standard-charges file dated 2026-08-06 (original file, csv_tall, 99 MB), checked by us on 2026-10-06. 101 of 300 common services found in it.
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Evaluation & Management
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Group Psychotherapy | CPT 90853 | $76.42 | $19.11 – $42.03 – $57.32 5 insurers | $76.42 |
Laboratory & Pathology
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Automated Urinalysis Test | CPT 81002 | $34.80 | $8.70 – $19.14 – $26.10 5 insurers | $34.80 |
| Automated Urinalysis Test | CPT 81003 | $22.50 | $5.63 – $12.38 – $16.88 5 insurers | $22.50 |
| Basic Metabolic Panel | CPT 80048 | $84.60 | $21.15 – $46.53 – $63.45 5 insurers | $84.60 |
| Blood Test, Clotting Time | CPT 85610 | $42.90 | $10.73 – $23.60 – $32.18 5 insurers | $42.90 |
| Blood Test, Comprehensive Group of Blood Chemicals | CPT 80053 | $105.60 | $26.40 – $58.08 – $79.20 5 insurers | $105.60 |
| Blood Test, Lipids (Cholesterol and Triglycerides) | CPT 80061 | $133.90 | $33.48 – $73.65 – $100.43 5 insurers | $133.90 |
| Blood Test, Thyroid Stimulating Hormone (Tsh) | CPT 84443 | $168.00 | $42.00 – $92.40 – $126.00 5 insurers | $168.00 |
| Coagulation Assessment Blood Test | CPT 85730 | $60.10 | $15.03 – $33.06 – $45.08 5 insurers | $60.10 |
| Complete Blood Cell Count, With Differential White Blood Cells, Automated | CPT 85025 | $77.70 | $19.43 – $42.74 – $58.28 5 insurers | $77.70 |
| Complete Blood Count, Automated | CPT 85027 | $64.70 | $16.18 – $35.59 – $48.53 5 insurers | $64.70 |
| Kidney Function Panel Test | CPT 80069 | $86.80 | $21.70 – $47.74 – $65.10 5 insurers | $86.80 |
| Liver Function Blood Test Panel | CPT 80076 | $81.70 | $20.43 – $44.94 – $61.28 5 insurers | $81.70 |
| Manual Urinalysis Test With Examination Using Microscope | CPT 81000 | $40.20 | $10.05 – $22.11 – $30.15 5 insurers | $40.20 |
| Manual Urinalysis Test With Examination Using Microscope | CPT 81001 | $31.70 | $7.93 – $17.44 – $23.78 5 insurers | $31.70 |
| Psa (Prostate Specific Antigen) | CPT 84153 | $183.90 | $45.98 – $101.15 – $137.93 5 insurers | $183.90 |
| Psa (Prostate Specific Antigen) | CPT 84154 | $183.90 | $45.98 – $101.15 – $137.93 5 insurers | $183.90 |
Radiology
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Ct Scan, Head Or Brain, Without Contrast | CPT 70450 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Ct Scan of Abdomen and Pelvis With Contrast | CPT 74177 | $1,693.35 | $423.34 – $931.35 – $1,270.01 5 insurers | $1,693.35 |
| Ct Scan, Pelvis, With Contrast | CPT 72193 | $821.33 | $205.33 – $451.74 – $616.00 5 insurers | $821.33 |
| Mammography, Screening, Bilateral | CPT 77067 | $444.59 | $111.15 – $244.53 – $333.44 5 insurers | $444.59 |
| Mri Scan of Brain Before and After Contrast | CPT 70553 | $1,693.35 | $423.34 – $931.35 – $1,270.01 5 insurers | $1,693.35 |
| Mri Scan of Leg Joint | CPT 73721 | $1,058.59 | $264.65 – $582.23 – $793.94 5 insurers | $1,058.59 |
| Mri Scan of Lower Spinal Canal | CPT 72148 | $1,058.59 | $264.65 – $582.23 – $793.94 5 insurers | $1,058.59 |
| Ultrasound of Abdomen | CPT 76700 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Ultrasound Pelvis Through Vagina | CPT 76830 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| X-Ray, Lower Back, Minimum Four Views | CPT 72110 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
Inpatient (volume)
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc | MS-DRG 897 | not published | $788.56 – $830.06 – $1,245.09 20 insurers | — |
| Degenerative Nervous System Disorders Without Mcc | MS-DRG 057 | not published | $921.37 – $969.86 – $1,454.79 20 insurers | — |
| Organic Disturbances and Intellectual Disability | MS-DRG 884 | not published | $896.47 – $943.65 – $1,415.48 20 insurers | — |
| Poisoning and Toxic Effects of Drugs With Mcc | MS-DRG 917 | not published | $987.77 – $1,039.76 – $1,559.64 20 insurers | — |
| Psychoses | MS-DRG 885 | not published | $830.06 – $873.75 – $1,310.63 20 insurers | — |
| Signs and Symptoms Without Mcc | MS-DRG 948 | not published | $904.77 – $952.39 – $1,428.59 20 insurers | — |
Outpatient/professional (volume)
| Service | Code | Cash price | Insurers pay (min – median – max) | Gross charge |
|---|---|---|---|---|
| Cell Examination of Specimen, Selective Cellular Enhancement Technique | CPT 88112 | $228.89 | $57.22 – $125.89 – $171.67 5 insurers | $228.89 |
| Complete Ultrasound Scan Behind Abdominal Cavity | CPT 76770 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Ct Scan of Abdomen and Pelvis Before and After Contrast | CPT 74178 | $1,693.35 | $423.34 – $931.35 – $1,270.01 5 insurers | $1,693.35 |
| Ct Scan of Abdomen and Pelvis Without Contrast | CPT 74176 | $1,058.59 | $264.65 – $582.23 – $793.94 5 insurers | $1,058.59 |
| Ct Scan of Blood Vessels of Abdomen and Pelvis With Contrast | CPT 74174 | $1,693.35 | $423.34 – $931.35 – $1,270.01 5 insurers | $1,693.35 |
| Ct Scan of Blood Vessels of Chest With Contrast | CPT 71275 | $821.33 | $205.33 – $451.74 – $616.00 5 insurers | $821.33 |
| Ct Scan of Blood Vessels of Head With Contrast | CPT 70496 | $821.33 | $205.33 – $451.74 – $616.00 5 insurers | $821.33 |
| Ct Scan of Blood Vessels of Neck With Contrast | CPT 70498 | $821.33 | $205.33 – $451.74 – $616.00 5 insurers | $821.33 |
| Ct Scan of Chest With Contrast | CPT 71260 | $821.33 | $205.33 – $451.74 – $616.00 5 insurers | $821.33 |
| Ct Scan of Chest Without Contrast | CPT 71250 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Ct Scan of Face Without Contrast | CPT 70486 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Ct Scan of Leg Without Contrast | CPT 73700 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Ct Scan of Lower Spine Without Contrast | CPT 72131 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Ct Scan of Upper Spine Without Contrast | CPT 72125 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Dxa Bone Density Measurement of Hip, Pelvis, Spine | CPT 77080 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Evaluation of Fine Needle Aspirate With Interpretation and Report | CPT 88173 | $228.89 | $57.22 – $125.89 – $171.67 5 insurers | $228.89 |
| Imaging For Evaluation of Swallowing Function | CPT 74230 | $821.33 | $205.33 – $451.74 – $616.00 5 insurers | $821.33 |
| Immunologic Analysis Technique On Serum (Immunofixation) | CPT 86334 | $223.40 | $55.85 – $122.87 – $167.55 5 insurers | $223.40 |
| Insertion of Artery Tube For Blood Sampling Or Infusion Through Skin | CPT 36620 | $762.00 | $190.50 – $419.10 – $571.50 5 insurers | $762.00 |
| Limited Ultrasound Scan of 1 Breast | CPT 76642 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| Limited Ultrasound Scan of Abdomen | CPT 76705 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Microscopic Genetic Analysis of Tumor, Manual | CPT 88360 | $686.13 | $171.53 – $377.38 – $514.60 5 insurers | $686.13 |
| Mri Scan of Abdomen Before and After Contrast | CPT 74183 | $1,693.35 | $423.34 – $931.35 – $1,270.01 5 insurers | $1,693.35 |
| Mri Scan of Brain Without Contrast | CPT 70551 | $1,058.59 | $264.65 – $582.23 – $793.94 5 insurers | $1,058.59 |
| Mri Scan of Upper Spinal Canal Without Contrast | CPT 72141 | $1,058.59 | $264.65 – $582.23 – $793.94 5 insurers | $1,058.59 |
| Nuclear Medicine Studies of Heart Muscle At Rest and With Stress and Spect | CPT 78452 | $6,007.32 | $1,501.83 – $3,304.03 – $4,505.49 5 insurers | $6,007.32 |
| Nuclear Medicine Study From Skull Base To Mid-Thigh With Ct Scan | CPT 78815 | $6,809.56 | $1,702.39 – $3,745.26 – $5,107.17 5 insurers | $6,809.56 |
| Pathology Examination of Tissue Using A Microscope, Intermediate Complexity | CPT 88305 | $228.89 | $57.22 – $125.89 – $171.67 5 insurers | $228.89 |
| Pathology Examination of Tissue Using A Microscope, Moderately High Complexity | CPT 88307 | $1,339.79 | $334.95 – $736.89 – $1,004.84 5 insurers | $1,339.79 |
| Pathology Examination of Tissue Using A Microscope, Moderately Low Complexity | CPT 88304 | $228.89 | $57.22 – $125.89 – $171.67 5 insurers | $228.89 |
| Preparation of Tissue For Examination By Removing Any Calcium Present | CPT 88311 | $92.90 | $23.23 – $51.10 – $69.68 5 insurers | $92.90 |
| Protein Measurement, Serum | CPT 84165 | $107.40 | $26.85 – $59.07 – $80.55 5 insurers | $107.40 |
| Psychiatric Diagnostic Evaluation With Medical Services | CPT 90792 | $614.69 | $153.67 – $338.08 – $461.02 5 insurers | $614.69 |
| Special Stained Specimen Slides To Examine Tissue, Each Additional Procedure | CPT 88341 | $249.37 | $62.34 – $137.16 – $187.03 5 insurers | $249.37 |
| Special Stained Specimen Slides To Examine Tissue Including Interpretation and Report | CPT 88313 | $155.66 | $38.92 – $85.62 – $116.75 5 insurers | $155.66 |
| Special Stained Specimen Slides To Examine Tissue, Initial Procedure | CPT 88342 | $686.13 | $171.53 – $377.38 – $514.60 5 insurers | $686.13 |
| Special Stained Specimen Slides To Identify Organisms Including Interpretation and Report | CPT 88312 | $228.89 | $57.22 – $125.89 – $171.67 5 insurers | $228.89 |
| Test To Determine Lung Volumes Using Sensors | CPT 94726 | $1,216.47 | $304.12 – $669.06 – $912.35 5 insurers | $1,216.47 |
| Test To Examine How Well The Lungs Exchange Gases | CPT 94729 | $404.00 | $101.00 – $222.20 – $303.00 5 insurers | $404.00 |
| Test To Measure Expiratory Airflow and Volume Changes Before and After Medication Administration | CPT 94060 | $1,216.47 | $304.12 – $669.06 – $912.35 5 insurers | $1,216.47 |
| Ultrasonic Guidance For Blood Vessel Access | CPT 76937 | $574.28 | $143.57 – $315.86 – $430.71 5 insurers | $574.28 |
| Ultrasonic Guidance For Needle Placement | CPT 76942 | $929.00 | $232.25 – $510.95 – $696.75 5 insurers | $929.00 |
| Ultrasound of Both Sides of Head and Neck Blood Flow | CPT 93880 | $1,058.59 | $264.65 – $582.23 – $793.94 5 insurers | $1,058.59 |
| Ultrasound of Heart Blood Flow, Valves and Chambers | CPT 93320 | $807.18 | $201.80 – $443.95 – $605.39 5 insurers | $807.18 |
| Ultrasound of Heart Blood Flow, Valves and Chambers, Follow-Up | CPT 93321 | $487.00 | $121.75 – $267.85 – $365.25 5 insurers | $487.00 |
| Ultrasound of Heart, Follow-Up | CPT 93308 | $1,058.59 | $264.65 – $582.23 – $793.94 5 insurers | $1,058.59 |
| Ultrasound of Heart With Color-Depicted Blood Flow, Rate and Valve Function | CPT 93325 | $686.00 | $171.50 – $377.30 – $514.50 5 insurers | $686.00 |
| Ultrasound of Heart With Color-Depicted Blood Flow, Rate, Direction and Valve Function | CPT 93306 | $2,221.29 | $555.32 – $1,221.71 – $1,665.97 5 insurers | $2,221.29 |
| Ultrasound of Heart With Probe In Esophagus, With Report | CPT 93312 | $2,221.29 | $555.32 – $1,221.71 – $1,665.97 5 insurers | $2,221.29 |
| Ultrasound Scan of Head and Neck Soft Tissue | CPT 76536 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| Ultrasound Study of Arm Or Leg Veins With Compression and Maneuvers | CPT 93970 | $1,058.59 | $264.65 – $582.23 – $793.94 5 insurers | $1,058.59 |
| Ultrasound Study of One Arm Or Leg Veins With Compression and Maneuvers | CPT 93971 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| X-Ray of Abdomen, 1 View | CPT 74018 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Ankle, Minimum of 3 Views | CPT 73610 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Chest, 1 View | CPT 71045 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Chest, 2 Views | CPT 71046 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Foot, Minimum of 3 Views | CPT 73630 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Hand, Minimum of 3 Views | CPT 73130 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Hip, 2-3 Views | CPT 73502 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Knee, 1-2 Views | CPT 73560 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Knee, 3 Views | CPT 73562 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Knee, 4 Or More Views | CPT 73564 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| X-Ray of Lower and Sacral Spine, 2-3 Views | CPT 72100 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| X-Ray of Lower Leg, 2 Views | CPT 73590 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Pelvis, 1-2 Views | CPT 72170 | $501.26 | $125.32 – $275.70 – $375.95 5 insurers | $501.26 |
| X-Ray of Shoulder, Minimum of 2 Views | CPT 73030 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Thigh Bone, Minimum 2 Views | CPT 73552 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |
| X-Ray of Wrist, Minimum of 3 Views | CPT 73110 | $372.14 | $93.04 – $204.68 – $279.11 5 insurers | $372.14 |